Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several ...Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczemaJAD and to propose Chinese diagnostic criteria for adult/adolescent AD. Methods： A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients （12 years and over） with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and-investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software. Results： A total of 2662 valid questionnaires were collected （1369 male and 1293 female）. Of all 2662 patients, 2062 （77.5%） patients had the disease after 12 years old, while only 600 （22.5%） patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine （80.4%） patients had the disease for more than 6 months. One thousand one hundred and forty-four （43.0%） patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight （58.2%） patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients. Conclusion： Late-onset of eczema or AD is common. Th展开更多
The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST, also called the Guo Shou Jing Telescope) is a special reflecting Schmidt telescope. LAMOST’s special design allows both a large aperture (effecti...The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST, also called the Guo Shou Jing Telescope) is a special reflecting Schmidt telescope. LAMOST’s special design allows both a large aperture (effective aperture of 3.6 m–4.9 m) and a wide field of view (FOV) (5°). It has an innovative active reflecting Schmidt configuration which continuously changes the mirror’s surface that adjusts during the observation process and combines thin deformable mirror active optics with segmented active optics. Its primary mirror (6.67m×6.05 m) and active Schmidt mirror (5.74m×4.40 m) are both segmented, and composed of 37 and 24 hexagonal sub-mirrors respectively. By using a parallel controllable fiber positioning technique, the focal surface of 1.75 m in diameter can accommodate 4000 optical fibers. Also, LAMOST has 16 spectrographs with 32 CCD cameras. LAMOST will be the telescope with the highest rate of spectral acquisition. As a national large scientific project, the LAMOST project was formally proposed in 1996, and approved by the Chinese government in 1997. The construction started in 2001, was completed in 2008 and passed the official acceptance in June 2009. The LAMOST pilot survey was started in October 2011 and the spectroscopic survey will launch in September 2012. Up to now, LAMOST has released more than 480 000 spectra of objects. LAMOST will make an important contribution to the study of the large-scale structure of the Universe, structure and evolution of the Galaxy, and cross-identification of multiwaveband properties in celestial objects.展开更多
Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. M...Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. Methods A cross-sectional, population-based survey of prevalence of asthrna was conducted in children aged from 0 to 14 years in 3 major cities of China （Beijing, Chongqing, and Guangzhou） with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase III questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question＂ Has your child ever been diagnosed as asthma by a doctor＂ were recognized as victims of asthma. Results The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria （x^2=3.938, P=-0.047; 22=73.506, P≤0.001; x^2=11.956, P=0.001, in each city）. Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children, followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females. Conclusion The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.展开更多
In this article, coke plant wastewater was treated by a simultaneous nitrifying and denitrifying （SND） fixed biofilm hybrid system. The results showed that suitable parameters of the system were important for the pe...In this article, coke plant wastewater was treated by a simultaneous nitrifying and denitrifying （SND） fixed biofilm hybrid system. The results showed that suitable parameters of the system were important for the performance of the bio-degradation system. The chemical oxygen demand （COD） removal efficiency in this system was satisfactory, higher than 94%, and ammonia nitrogen was higher than 95%. The effluent COD concentration could meet the discharge standard, except for very few situations. The results showed that a sufficient carbon source was important for making ammonia nitrogen concentration meet the discharge standard. Then the TiN removal efficiency in this system can be brought higher than 94%. Dissolved oxygen （DO） is very important to the performance of the SND bio-degradation system, and the suitable DO is about 3.5-4.0 mg/L at the forepart of reactor. In addition, the performance of the system was almost not affected by pH value. The results show that the system is feasible to treat coke plant wastewater.展开更多
The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of ...The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of stars, galaxies and QSOs. Objects in both the pilot survey and the first year regular survey are included in the LAMOST DR1. The pilot survey started in October 2011 and ended in June 2012, and the data have been released to the public as the LAMOST Pilot Data Release in August 2012. The regular survey started in September 2012, and completed its first year of operation in June 2013. The LAMOST DR1 includes a total of 1202 plates containing 2 955 336 spectra, of which 1 790 879 spectra have observed signalto-noise ratio（SNR） ≥ 10. All data with SNR ≥ 2 are formally released as LAMOST DR1 under the LAMOST data policy. This data release contains a total of 2 204 696 spectra, of which 1 944 329 are stellar spectra, 12 082 are galaxy spectra and 5017 are quasars. The DR1 not only includes spectra, but also three stellar catalogs with measured parameters： late A,FGK-type stars with high quality spectra（1 061 918 entries）, A-type stars（100 073 entries）, and M-type stars（121 522 entries）. This paper introduces the survey design, the observational and instrumental limitations, data reduction and analysis, and some caveats. A description of the FITS structure of spectral files and parameter catalogs is also provided.展开更多
Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patien...Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence.Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions,etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology.The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidencebased consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.展开更多
BACKGROUND: Sepsis is a common complication ofinfections, burns, traumas, surgeries, poisonings, and post-cardiopulmonary resuscitation. The present study aimed to investigate prognostic value of CD4+CD25+ regulatory ...BACKGROUND: Sepsis is a common complication ofinfections, burns, traumas, surgeries, poisonings, and post-cardiopulmonary resuscitation. The present study aimed to investigate prognostic value of CD4+CD25+ regulatory T cells(Treg) in peripheral blood of patients with sepsis.METHODS: Periphery blood from 28 patients diagnosed with sepsis was collected on day 1 and 7 after hospitalization in the ICU of Shanghai Changzheng Hospital between December 2013 to April 2014. The blood was used for analyses of Treg ratio using flow cytometry and for analyses of blood routine test, C-reactive protein(CRP), bilirubin, procalcitonin(PCT), and coagulation. APACHE II and sequential organ failure assessment(SOFA) scores were also investigated. The results were compared between two outcome groups of survival or death to evaluate prognostic value for sepsis.RESULTS: The patients had an average age of 60.36±15.03 years, APACHE II score 16.68±7.00, and SOFA score 7.18±3.78. Among the 28 patients, 12 had severe trauma(42.9%), 10 had septic shock(35.7%), and 9(32.2%) died. The median ratio of Tregs was 2.10%(0.80%, 3.10%) in the survival group vs. 1.80%(1.15%, 3.65%) in the death group(Z=–0.148, P=0.883) on day 1; however it was signifi cantly changed to 0.90%(0.30%, 2.80%) vs. 5.70%(2.60%, 8.30%)(Z=–2.905, P=0.004).CONCLUSION: With better prospects for clinical application, dynamic monitoring of Tregs ratio in peripheral blood has potential value in predicting prognosis of sepsis.展开更多
Coal and gas outburst is a frequent dynamic disaster during underground coal mining activities.After about 150 years of exploration,the mechanisms of outbursts remain unclear to date.Studies on outburst mechanisms wor...Coal and gas outburst is a frequent dynamic disaster during underground coal mining activities.After about 150 years of exploration,the mechanisms of outbursts remain unclear to date.Studies on outburst mechanisms worldwide focused on the physicochemical and mechanical properties of outburst-prone coal,laboratory-scale outburst experiments and numerical modeling,mine-site investigations,and doctrines of outburst mechanisms.Outburst mechanisms are divided into two categories:single-factor and multi-factor mechanisms.The multi-factor mechanism is widely accepted,but all statistical phenomena during a single outburst cannot be explained using present knowledge.Additional topics about outburst mechanisms are proposed by summarizing the phenomena that need precise explanation.The most appealing research is the microscopic process of the interaction between coal and gas.Modern physical-chemical methods can help characterize the natural properties of outburst-prone coal.Outburst experiments can compensate for the deficiency of first-hand observation at the scene.Restoring the original outburst scene by constructing a geomechanical model or numerical model and reproducing the entire outburst process based on mining environment conditions,including stratigraphic distribution,gas occurrence,and geological structure,are important.Future studies can explore outburst mechanisms at the microscale.展开更多
Objective To evaluate the present Chinese body mass index （BMI） criteria with body fat percentage （BF%） in determining obesity in Chinese population. Methods A total of 4 907 subjects （age： 20-90 yrs） were enro...Objective To evaluate the present Chinese body mass index （BMI） criteria with body fat percentage （BF%） in determining obesity in Chinese population. Methods A total of 4 907 subjects （age： 20-90 yrs） were enrolled in the baselirie survey of a longitudinal epidemiological study, and 2 638 of them were reevaluated in 5.5 years later. The Chinese BMI and WHO BF% were used to define obesity, respectively. Results The diagnostic agreement between the Chinese BMI and WHO BF% definitions for obesity was poor for both men （kappa： 0.210, 95% CI： 0.179-0.241） and women （kappa： 0.327, 95% CI： 0.296-0.358）. However, BMI had a good correlation with BF% both in men （r： 0.785, P〈0.01） and women （r： 0.864, P〈0.01）. The age and sex-adjusted relative risks （RR） for incidence of type 2 diabetes （T2DM） were significantly higher in subjects with intermediate BF% （BF%：20.1%-25% for men, 30.1%-35% for women） （RR： 2.35, 95% CI： 1.23-4.48） and high BF%（BF%〉25% for men and 〉35% for women）（RR： 2.89, 95% CI： 1.43-5.81）, or in subjects with high BMI （BMI≥ 28 kg/m2） （RR： 2.46, 95% CI： 1.31-4.63） when compared to those with low BF% （BF%≤20% for men ands〈30% for women） or low BMI （BMI〈24 kg/m^2） respectively. No difference in risk could be found in those with intermediate BMI （BMI： 24-27.9 kg/m^2） （RR： 1.44, 95% CI： 0.86-2.40）, as compared to those with low BMI （BMI〈24 kg/m^2）, whose BF% ranged widely from 7.8 to 50.3%. Conclusion BMI was correlated with BF%. Both BMI and BF% were associated with high risk for T2DM. However, BMI had its limitations in the interpretation of subjects with BMI between 24 and 27.9 kg/m^2.展开更多
AIM: To investigate the prognostic value of preoperative lymphocyte-to-monocyte ratio(LMR) in patients with hepatocellular carcinoma(HCC) undergoing curative hepatectomy.METHODS: Clinicopathological data of 210 hepati...AIM: To investigate the prognostic value of preoperative lymphocyte-to-monocyte ratio(LMR) in patients with hepatocellular carcinoma(HCC) undergoing curative hepatectomy.METHODS: Clinicopathological data of 210 hepatitis B virus(HBV)-associated HCC patients who were treated by radical hepatic resection between 2003 and 2010 were retrospectively analyzed. None of the patients received any preoperative anticancer therapyor intraoperative radiofrequency ablation. The diagnosis was confirmed by pathological examination after surgery. Absolute peripheral blood lymphocyte and monocyte counts were derived from serum complete blood cell count before surgery,and LMR was calculated by dividing lymphocyte count by monocyte count. The best cutoff was determined by receiver operating characteristics(ROC) curve analysis. Correlations between LMR levels and clinicopathological features were assessed using the χ2 test. Survival outcomes were estimated using the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariate analyses were performed to evaluate the prognostic impact of LMR and other clinicopathological factors on overall survival(OS) and recurrence-free survival(RFS),using the Cox proportional hazards model.RESULTS: The optimal cutoff value of LMR for survival analysis was 3.23,which resulted in the most appropriate sensitivity of 55.3% and specificity of 74.7%,with the area under the curve(AUC) of 0.66(95%CI: 0.593-0.725). All patients were dichotomized into either a low(≤ 3.23) LMR group(n = 66) or a high(> 3.23) LMR group(n = 144). A low preoperative LMR level was significantly correlated with the presence of cirrhosis,elevated levels of total bilirubin and larger tumor size. Patients with a low LMR level had significantly reduced 5-year OS(61.9% vs 83.2%,P < 0.001) and RFS(27.8% vs 47.6%,P = 0.009) compared to those with a high LMR level. Multivariate analyses indicated that a lower LMR level was a significantly independent predictor of inferior OS(P = 0.003) and RFS(P = 0.006). Subgroup 展开更多
Hard carbon is the most promising anode for sodium-ion battery applications due to the wide availability and low work voltage.However,it often delivers worse electrochemical performance in ester-based electrolytes.Her...Hard carbon is the most promising anode for sodium-ion battery applications due to the wide availability and low work voltage.However,it often delivers worse electrochemical performance in ester-based electrolytes.Herein,a hierarchically porous loose sponge-like hard carbon with a highly disordered phase,prepared from the biomass of platanus bark,exhibits superior rate performance with a capacity of 165 mAh·g-1 at a high current of1 A·g-1,and high retention of 71.5%after 2000 cycles in an ester-based electrolyte.The effect of the hierarchically porous loose sponge-like structure on the formation dynamics of solid electrolyte interphase(SEI),and related properties,was studied via cyclic voltammetry(CV),galvanostatic intermittent titration technique(GITT),X-ray photoelectron spectroscope(XPS),Fourier transform infrared spectroscopy(FTIR)and electrochemical impedance spectroscopy(EIS)analysis.These results reveal that the hierarchically porous structure can construct continued connecting channels and accelerate the electrolyte transport,which is beneficial to the reaction kinetics of SEI.Moreover,the mesoporous structure is conducive to good contact between electrolyte and materials and shortens the Na+diffusion path,which in turn facilitates the charge transfer kinetics in the material.展开更多
文摘Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczemaJAD and to propose Chinese diagnostic criteria for adult/adolescent AD. Methods： A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients （12 years and over） with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and-investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software. Results： A total of 2662 valid questionnaires were collected （1369 male and 1293 female）. Of all 2662 patients, 2062 （77.5%） patients had the disease after 12 years old, while only 600 （22.5%） patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine （80.4%） patients had the disease for more than 6 months. One thousand one hundred and forty-four （43.0%） patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight （58.2%） patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients. Conclusion： Late-onset of eczema or AD is common. Th
文摘The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST, also called the Guo Shou Jing Telescope) is a special reflecting Schmidt telescope. LAMOST’s special design allows both a large aperture (effective aperture of 3.6 m–4.9 m) and a wide field of view (FOV) (5°). It has an innovative active reflecting Schmidt configuration which continuously changes the mirror’s surface that adjusts during the observation process and combines thin deformable mirror active optics with segmented active optics. Its primary mirror (6.67m×6.05 m) and active Schmidt mirror (5.74m×4.40 m) are both segmented, and composed of 37 and 24 hexagonal sub-mirrors respectively. By using a parallel controllable fiber positioning technique, the focal surface of 1.75 m in diameter can accommodate 4000 optical fibers. Also, LAMOST has 16 spectrographs with 32 CCD cameras. LAMOST will be the telescope with the highest rate of spectral acquisition. As a national large scientific project, the LAMOST project was formally proposed in 1996, and approved by the Chinese government in 1997. The construction started in 2001, was completed in 2008 and passed the official acceptance in June 2009. The LAMOST pilot survey was started in October 2011 and the spectroscopic survey will launch in September 2012. Up to now, LAMOST has released more than 480 000 spectra of objects. LAMOST will make an important contribution to the study of the large-scale structure of the Universe, structure and evolution of the Galaxy, and cross-identification of multiwaveband properties in celestial objects.
基金supported by the National Science & Technology Pillar Program under the Eleventh Five-Year Plan of China(No.2007BAI24B05)
文摘Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. Methods A cross-sectional, population-based survey of prevalence of asthrna was conducted in children aged from 0 to 14 years in 3 major cities of China （Beijing, Chongqing, and Guangzhou） with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase III questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question＂ Has your child ever been diagnosed as asthma by a doctor＂ were recognized as victims of asthma. Results The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria （x^2=3.938, P=-0.047; 22=73.506, P≤0.001; x^2=11.956, P=0.001, in each city）. Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children, followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females. Conclusion The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.
文摘In this article, coke plant wastewater was treated by a simultaneous nitrifying and denitrifying （SND） fixed biofilm hybrid system. The results showed that suitable parameters of the system were important for the performance of the bio-degradation system. The chemical oxygen demand （COD） removal efficiency in this system was satisfactory, higher than 94%, and ammonia nitrogen was higher than 95%. The effluent COD concentration could meet the discharge standard, except for very few situations. The results showed that a sufficient carbon source was important for making ammonia nitrogen concentration meet the discharge standard. Then the TiN removal efficiency in this system can be brought higher than 94%. Dissolved oxygen （DO） is very important to the performance of the SND bio-degradation system, and the suitable DO is about 3.5-4.0 mg/L at the forepart of reactor. In addition, the performance of the system was almost not affected by pH value. The results show that the system is feasible to treat coke plant wastewater.
基金funded by the National Basic Research Program of China (973 Program, 2014CB845700)the National Natural Science Foundation of China (Grant Nos. 11390371)Funding for the project has been provided by the National Development and Reform Commission
文摘The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of stars, galaxies and QSOs. Objects in both the pilot survey and the first year regular survey are included in the LAMOST DR1. The pilot survey started in October 2011 and ended in June 2012, and the data have been released to the public as the LAMOST Pilot Data Release in August 2012. The regular survey started in September 2012, and completed its first year of operation in June 2013. The LAMOST DR1 includes a total of 1202 plates containing 2 955 336 spectra, of which 1 790 879 spectra have observed signalto-noise ratio（SNR） ≥ 10. All data with SNR ≥ 2 are formally released as LAMOST DR1 under the LAMOST data policy. This data release contains a total of 2 204 696 spectra, of which 1 944 329 are stellar spectra, 12 082 are galaxy spectra and 5017 are quasars. The DR1 not only includes spectra, but also three stellar catalogs with measured parameters： late A,FGK-type stars with high quality spectra（1 061 918 entries）, A-type stars（100 073 entries）, and M-type stars（121 522 entries）. This paper introduces the survey design, the observational and instrumental limitations, data reduction and analysis, and some caveats. A description of the FITS structure of spectral files and parameter catalogs is also provided.
基金supported by Improving the Ability of Diagnosis and Treatment of Difficult Diseases (ZLYNXM202009)。
文摘Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence.Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions,etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology.The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidencebased consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.
文摘BACKGROUND: Sepsis is a common complication ofinfections, burns, traumas, surgeries, poisonings, and post-cardiopulmonary resuscitation. The present study aimed to investigate prognostic value of CD4+CD25+ regulatory T cells(Treg) in peripheral blood of patients with sepsis.METHODS: Periphery blood from 28 patients diagnosed with sepsis was collected on day 1 and 7 after hospitalization in the ICU of Shanghai Changzheng Hospital between December 2013 to April 2014. The blood was used for analyses of Treg ratio using flow cytometry and for analyses of blood routine test, C-reactive protein(CRP), bilirubin, procalcitonin(PCT), and coagulation. APACHE II and sequential organ failure assessment(SOFA) scores were also investigated. The results were compared between two outcome groups of survival or death to evaluate prognostic value for sepsis.RESULTS: The patients had an average age of 60.36±15.03 years, APACHE II score 16.68±7.00, and SOFA score 7.18±3.78. Among the 28 patients, 12 had severe trauma(42.9%), 10 had septic shock(35.7%), and 9(32.2%) died. The median ratio of Tregs was 2.10%(0.80%, 3.10%) in the survival group vs. 1.80%(1.15%, 3.65%) in the death group(Z=–0.148, P=0.883) on day 1; however it was signifi cantly changed to 0.90%(0.30%, 2.80%) vs. 5.70%(2.60%, 8.30%)(Z=–2.905, P=0.004).CONCLUSION: With better prospects for clinical application, dynamic monitoring of Tregs ratio in peripheral blood has potential value in predicting prognosis of sepsis.
基金financially supported by the State Key Research Development Program of China(No.2016YFC0600708)the Fundamental Research Funds for the Central Universities(No.2009kz03)+1 种基金the Scientific and Technological Innovation Leading Talents of“Ten thousand plan”of the Organization Department of the Central Committee of the CPC(No.W02020049)the International Clean Energy Talent Program of State Scholarship Fund of China Scholarship Council(No.201902720011)。
文摘Coal and gas outburst is a frequent dynamic disaster during underground coal mining activities.After about 150 years of exploration,the mechanisms of outbursts remain unclear to date.Studies on outburst mechanisms worldwide focused on the physicochemical and mechanical properties of outburst-prone coal,laboratory-scale outburst experiments and numerical modeling,mine-site investigations,and doctrines of outburst mechanisms.Outburst mechanisms are divided into two categories:single-factor and multi-factor mechanisms.The multi-factor mechanism is widely accepted,but all statistical phenomena during a single outburst cannot be explained using present knowledge.Additional topics about outburst mechanisms are proposed by summarizing the phenomena that need precise explanation.The most appealing research is the microscopic process of the interaction between coal and gas.Modern physical-chemical methods can help characterize the natural properties of outburst-prone coal.Outburst experiments can compensate for the deficiency of first-hand observation at the scene.Restoring the original outburst scene by constructing a geomechanical model or numerical model and reproducing the entire outburst process based on mining environment conditions,including stratigraphic distribution,gas occurrence,and geological structure,are important.Future studies can explore outburst mechanisms at the microscale.
基金funded by the Major Program of Shanghai Municipality for Basic Research(08dj 1400601)the Shanghai Pujiang Program(OTpj14062)Projeot for Shanghai key Laboratlry of Diabetes Mellitus(08DZ2230200).
文摘Objective To evaluate the present Chinese body mass index （BMI） criteria with body fat percentage （BF%） in determining obesity in Chinese population. Methods A total of 4 907 subjects （age： 20-90 yrs） were enrolled in the baselirie survey of a longitudinal epidemiological study, and 2 638 of them were reevaluated in 5.5 years later. The Chinese BMI and WHO BF% were used to define obesity, respectively. Results The diagnostic agreement between the Chinese BMI and WHO BF% definitions for obesity was poor for both men （kappa： 0.210, 95% CI： 0.179-0.241） and women （kappa： 0.327, 95% CI： 0.296-0.358）. However, BMI had a good correlation with BF% both in men （r： 0.785, P〈0.01） and women （r： 0.864, P〈0.01）. The age and sex-adjusted relative risks （RR） for incidence of type 2 diabetes （T2DM） were significantly higher in subjects with intermediate BF% （BF%：20.1%-25% for men, 30.1%-35% for women） （RR： 2.35, 95% CI： 1.23-4.48） and high BF%（BF%〉25% for men and 〉35% for women）（RR： 2.89, 95% CI： 1.43-5.81）, or in subjects with high BMI （BMI≥ 28 kg/m2） （RR： 2.46, 95% CI： 1.31-4.63） when compared to those with low BF% （BF%≤20% for men ands〈30% for women） or low BMI （BMI〈24 kg/m^2） respectively. No difference in risk could be found in those with intermediate BMI （BMI： 24-27.9 kg/m^2） （RR： 1.44, 95% CI： 0.86-2.40）, as compared to those with low BMI （BMI〈24 kg/m^2）, whose BF% ranged widely from 7.8 to 50.3%. Conclusion BMI was correlated with BF%. Both BMI and BF% were associated with high risk for T2DM. However, BMI had its limitations in the interpretation of subjects with BMI between 24 and 27.9 kg/m^2.
基金Supported by National Natural Science Foundation of China,No.81372374the Combination Project of Production,Education and Research from Guangdong Province and Ministry of Education,No.2012B091100460the Natural Science Foundation of Guangdong,No.2014A030313146
文摘AIM: To investigate the prognostic value of preoperative lymphocyte-to-monocyte ratio(LMR) in patients with hepatocellular carcinoma(HCC) undergoing curative hepatectomy.METHODS: Clinicopathological data of 210 hepatitis B virus(HBV)-associated HCC patients who were treated by radical hepatic resection between 2003 and 2010 were retrospectively analyzed. None of the patients received any preoperative anticancer therapyor intraoperative radiofrequency ablation. The diagnosis was confirmed by pathological examination after surgery. Absolute peripheral blood lymphocyte and monocyte counts were derived from serum complete blood cell count before surgery,and LMR was calculated by dividing lymphocyte count by monocyte count. The best cutoff was determined by receiver operating characteristics(ROC) curve analysis. Correlations between LMR levels and clinicopathological features were assessed using the χ2 test. Survival outcomes were estimated using the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariate analyses were performed to evaluate the prognostic impact of LMR and other clinicopathological factors on overall survival(OS) and recurrence-free survival(RFS),using the Cox proportional hazards model.RESULTS: The optimal cutoff value of LMR for survival analysis was 3.23,which resulted in the most appropriate sensitivity of 55.3% and specificity of 74.7%,with the area under the curve(AUC) of 0.66(95%CI: 0.593-0.725). All patients were dichotomized into either a low(≤ 3.23) LMR group(n = 66) or a high(> 3.23) LMR group(n = 144). A low preoperative LMR level was significantly correlated with the presence of cirrhosis,elevated levels of total bilirubin and larger tumor size. Patients with a low LMR level had significantly reduced 5-year OS(61.9% vs 83.2%,P < 0.001) and RFS(27.8% vs 47.6%,P = 0.009) compared to those with a high LMR level. Multivariate analyses indicated that a lower LMR level was a significantly independent predictor of inferior OS(P = 0.003) and RFS(P = 0.006). Subgroup
基金financially supported by the National Natural Science Foundation of China(Nos.U1804129,21771164,21671205 and U1804126)Zhongyuan Youth Talent Support Program of Henan Province and Zhengzhou University Youth Innovation Program。
文摘Hard carbon is the most promising anode for sodium-ion battery applications due to the wide availability and low work voltage.However,it often delivers worse electrochemical performance in ester-based electrolytes.Herein,a hierarchically porous loose sponge-like hard carbon with a highly disordered phase,prepared from the biomass of platanus bark,exhibits superior rate performance with a capacity of 165 mAh·g-1 at a high current of1 A·g-1,and high retention of 71.5%after 2000 cycles in an ester-based electrolyte.The effect of the hierarchically porous loose sponge-like structure on the formation dynamics of solid electrolyte interphase(SEI),and related properties,was studied via cyclic voltammetry(CV),galvanostatic intermittent titration technique(GITT),X-ray photoelectron spectroscope(XPS),Fourier transform infrared spectroscopy(FTIR)and electrochemical impedance spectroscopy(EIS)analysis.These results reveal that the hierarchically porous structure can construct continued connecting channels and accelerate the electrolyte transport,which is beneficial to the reaction kinetics of SEI.Moreover,the mesoporous structure is conducive to good contact between electrolyte and materials and shortens the Na+diffusion path,which in turn facilitates the charge transfer kinetics in the material.
